NP Role Final Exam 2024: Actual Exam Test with Detailed Answers and Rationales, Exams of Nursing

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NP ROLE FINAL EXAM 2024 ACTUAL EXAM TEST

BANK WITH REAL QUESTIONS AND CORRECT

DETAILED ANSWERS WITH RATIONALES

(VERIFIED ANSWERS) | A+ GRADE

1.Explain the impact of healthcare disparities and vulnerability on health outcomes. ANSWER: HealthCare disparities comprise differences in healthcare quality among individuals or groups with regard to access, treatment options, and preventative services. Segments of the global population experience social inequalities and are at risk for poor health outcomes. While any individual can become vulnerable at any point in their life, as documented in the literature, health outcomes and vulnerability fall along a social gradient and poorer people experience poorer health.

2. For the culturally competent nurse practitioner, the delivery of patient care is influenced by which principle? a. High-income countries are not subject to health disparities. b. Access to primary health care services is a human right. c. Gaps in health outcomes between different groups of people are inevitable. d. Certain forms of health inequities are considered to be fair and just. ANSWER: Access to primary health care services is a human right. 3.The nurse practitioner explores a patient's social determinants of health. When assessing lifestyle and behaviors, which question does the nurse practitioner ask the patient? a. "Do you use tobacco products?"

b. "Are you currently employed?" c. "Do you have sufficient food?" d. "What is your level of education?" ANSWER: “Do you use tobacco products?" 4.The nurse practitioner plans to advocate for improving access to health care among all populations. Which strategy does the nurse practitioner implement to advocate at the macrosystem level? a. Becoming motivated to act on the behalf of other individuals b. Developing cultural skills c. Working through the chain of command of a healthcare organization d. Gaining insight into self ANSWER: Working through the chain of command of a healthcare organization 5.Describe key social and environmental factors that coexist with poverty. ANSWER: Beyond representing strictly a socioeconomic issue, poverty impacts health, well- being, and quality of life for generations to come. Key social and environmental factors that coexist with poverty include poor housing; inadequate nutrition; lack of clean water; increased exposure to violence; fragmented health care; and a higher prevalence of physical illness, mental health issues, and disabilities. 6.Discuss factors that contribute to financial insecurity among the elderly. ANSWER: While social security income is often identified as a protective

factor against elderly poverty, increases in the life expectancy of the elderly over time mean that financial resources have to last longer. Simultaneously, healthcare and housing costs are rising and employer benefit pension plans have decreased. As a result, elderly individuals face significant insecurity about whether or not their resources are sufficient to cover the duration of their lives after retirement. Discuss transgenerational trauma and its impact on disease development. ANSWER: Trans-generational or intergenerational trauma comprises wounding from a traumatic event that produces effects upon generations after the initial trauma. Trans generational trauma may occur in individual families. In addition, trans generational trauma may occur among groups who have experienced various traumatic events (such as genocide, terrorism, and natural disasters) as collective trauma. For both individuals and groups, long-lasting harmful effects on physiological processes in the body may lead to the development of chronic disease Describe the nurse practitioner's approach to assessing and assisting an individual who may be subject to human trafficking. ANSWER: The NP must be educated on identifying victims of human trafficking, developing culturally appropriate caring patient/provider relationships, becoming knowledgeable on reporting laws, and assisting colleagues to better identify and refer potential victims. Potential indicators of trafficking include (a) being accompanied by someone who appears to be controlling the individual and the scenario; (b) fear; (c) sadness; (d) bruises and other traumatic injuries; (e) lack of documentation; (f) discrepancy of behavior and reported age; and (g) generally poor health. Recommended approaches to assessment of individuals who may be subject to human trafficking include (a) assuring safety and confidentiality as a primary step; (b) asking about the individual's living arrangements and freedom to come and go at will; (c) asking if the individual is subject to threats or harm; and (d) asking if the individual has been forced to have sex or perform sex acts. Useful laboratory testing Includes complete blood count, STD testing (including HIV), ova and parasites,

hepatitis B and C, and tuberculosis. By working as a team with social services and law enforcement, the NP can help get the victim to safety and into services to assist transitioning to safe housing with long-term treatment for psychological and medical issues. When discussing gender and sexuality, a patient identifies as being "gender fluid." The nurse practitioner understands the patient's gender identification to be reflective of which self- perception? a. The patient does not identify with any gender. b. The patient identifies as mixed or neutral gender. c. The patient identifies with the gender assigned at birth. d. The patient's gender is not static but shifts. ANSWER: The patient's gender is not static but shifts. When discussing sexual orientation, the patient tells the nurse practitioner, "I view myself as being female, but I am attracted to other people regardless of how they view their gender or gender identity." Which sexual preference best describes the patient's perspective? a. Pansexual b. Homosexual c. Asexual d. Bisexu al ANSWE R:Pansex ual Research suggests the delivery of disparate health services is most prevalent among patients who receive mental health treatment in which setting? a. Primary care b. Psychiatric

c. Community health d. Pediatric ANSWER: Primary care The term "co-occurring diagnosis" best describes a patient who is diagnosed with which concurrent health alterations? a. Schizophrenia and opioid abuse disorder b. Emphysema and chronic bronchitis c. Hypertension and borderline personality disorder d. Bipolar depression and conduct disorder ANSWER: Schizophrenia and opioid abuse disorder Which disorder most significantly impacts out-of-home placement for children? a. Conduct disorder b. Autism spectrum disorder c. Post-traumatic stress disorder d. Substance use disorder ANSWER: Substance

use disorder Which single intervention is most appropriate for the nurse practitioner to consider including in the plan of care for a patient who is struggling with opioid and marijuana dependencies? a. Buprenorphine b. Motivational interviewing c. Naltrexone d. Family psychotherapy ANSWER: Motivational interviewing Discuss health outcomes associated with alterations in cortisol release secondary to chronic stress and traumatic events. ANSWER: Systemic cortisol release enables the body to respond to stressful stimuli. However, stress and traumatic events may lead to alterations in the hypothalamic-pituitary- adrenal (HPA) axis. For example, individuals who experience chronic stress may be subject to excessive cortisol production or to cortisol release in response to nonthreatening stimuli. In animal studies, researchers found that excessive cortisol release and increased HPA axis reactivity may be linked to an increased risk for developing depression. Decreased HPA reactivity and an associated blunted cortisol response also have health implications. Lower

HPA reactivity is associated with social and behavioral challenges during both childhood and adulthood. Blunted cortisol release has been studied with childhood victims of abuse and bullying. Indirect victims of trauma, such as children who witness interpersonal conflict between caregivers, have also been observed to demonstrate a low cortisol response rate. Discuss the relationship between housing instability among women and intimate partner violence. Women are especially vulnerable to issues related to housing instability. A bidirectional relationship exists between housing instability and intimate partner violence. For women who are financially dependent on an abusive partner, lack of housing options represents a significant barrier to leaving the abusive relationship. In turn, future housing instability can be predicted based on having experienced intimate partner violence. The nurse practitioner (NP) identifies which personal characteristic as a potential manifestation of vicarious traumatization (VT)? a. Scheduling time off work b. Seeking peer socialization c. Empathizing with clients d. Experiencing somatization Experiencing somatization

Explain the bidirectional nature of dual diagnosis. General risk factors are often present for both mental illness and substance use. Substance use may be secondary to a psychiatric disorder; however, a psychiatric disorder may also develop secondary to substance abuse. Commonly, dual-diagnosis is bidirectional, meaning the conditions contribute to one other. Explain the importance of including suicide screening during risk assessment for members of the general, adolescent, and geriatric populations. For all risk assessments, suicide screening is a key component. In the United States, according to the Centers for Disease Control and Prevention (CDC), suicide is the 10th leading cause of death and is responsible for 1% of fatalities. The primary care setting provides the greatest opportunity for suicide screening. Recent research indicated individuals who committed suicide visited their primary care provider within a month of the suicidal act. Members of the adolescent and geriatric populations are at high risk for suicidality. Because adolescents and geriatric patients typicallysee their primary care provider at least once per year, suicide screening should be included as part of routine office visits for members of these populations.

Describe two key factors that contribute to misdiagnosis of bipolar depression as unipolar depression. Key factors that contribute to misdiagnosis of bipolar depression as unipolar depression include that depression is a common symptom of bipolar disorder. Without more extensive patient reporting, misdiagnosis of bipolar depression as unipolar depression is likely to occur. Additionally, patients often fail to recall manic episodes.

Explain how delivering patient care based on the Golden Rule may impede cultural competence. In Western culture, the Golden Rule is one of the most familiar moral values. The Golden Rule is "Do unto others as you would have them do unto you." While the Golden Rule is rooted in good intentions, in health care, this value presumes that all individuals prefer to be treated in a manner that is congruent with the healthcare provider's personal standards and beliefs without consideration of individual preferences. Beyond following the Golden rule, culturally competent care requires the nurse practitioner (NP) to consider the patient's individual preferences. Which concept centers on a belief that the culture with which the individual is most familiar represents the cultural standard? a. Polarization b. Ethnocentrism c. Acculturation d. Stereotypin g Ethnocentrism

Differentiate between the "melting pot" and the "tossed salad" perspectives in application to cultural awareness in the United States. Considering the United States as a "melting pot," or the blending together of various cultures to form one, does not take into account the unique qualities of the various cultures that form the population. By contrast, perceiving the United States as a "tossed salad" represents a more culturally aware perspective through which the diversity of the culture is valued for what it contributes to the whole. The nurse practitioner (NP) applies Giger and Davidhizar's "transcultural assessment model" during patient assessment. Which statement by the patient is most useful for determining the patient's perception of environmental control? a. "God will decide whether or not I get well." b. "Several of my relatives have sickle cell anemia." c. "My parents think I need to drink more water." d. "I am not comfortable with strangers touching me." "God will decide whether or not I get well." Which action by the nurse practitioner is most reflective of cultural humility? a. Developing competence regarding all cultures served in a specific setting b. Acknowledging limitations in understanding a patient's cultural background c. Viewing the patient's circumstances from the NP's perspective d. Learning about a specific cultural group's beliefs and preferences

Acknowledging limitations in understanding a patient's cultural background The nurse practitioner (NP) is preparing to assess a Native American patient. Which strategy demonstrates cultural sensitivity by the NP? a. Understanding the patient may avoid eye contact b. Anticipating that the patient may be quiet until trust is established c. Desiring to learn about the patient's use of herbal remedies d. Recognizing the patient may prefer to collaborate with a folk healer Desiring to learn about the patient's use of herbal remedies Summarize the impact of cultural immersion experiences on cultural competency. Research indicates cultural immersion experiences enhance cultural awareness and sensitivity. In addition, research suggests an individual's beliefs regarding a cultural group are affected by interacting with various culturally diverse groups, which prevents stereotyping.

Discuss the importance of combining cultural awareness training with nurse practitioner-client partnerships to impact health outcomes for disparate populations. Cultural awareness training may be helpful in increasing cultural awareness. However, simply completing cultural awareness training is not a guaranteed means by which to improve health outcomes for disparate populations. Cultural awareness becomes significant when the healthcare provider recognizes the influence of culture on a person's existence. Partnership between the NP and the client can help the NP gain a better understanding and appreciation of the client's culturally specific needs in the context of the client's population. Summarize the purpose and goals of the Office of Minority Health (OMH) Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS standards). The Office of Minority Health (OMH) Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS standards) were developed for use by healthcare systems to promote delivery of the best possible care for the diverse patient populations who seek care in the United States. Goals

of the CLAS standards include (a) advancing health equity; (b) improving quality; and (c) helping eliminate healthcare disparities. The 14 CLAS standards guide the nurse practitioner (NP) and other healthcare providers to the recommended language and communication processes in healthcare settings that will enhance patient care outcomes. The nurse practitioner's demonstration of cultural competence includes which intervention? a. Achieving consensus on differing values b. Using colloquial expressions when speaking c. Identifying stereotypes held by others

d. Establishing boundaries for acceptable behaviors Establishing boundaries for acceptable behaviors Unique aspects of a nurse practitioner (NP) preceptorship in an acute care setting include which consideration? a. Cultural competence b. Credentialing c. Clinical experience d. Collaboratio n Credentialing Explain the role of the clinical advisor in relationship to the nurse practitioner (NP) student and the preceptor. Clinical advisors are either full-time faculty or adjunct faculty who are NPs that are responsible for overseeing the clinical experiences of up to six NP students.

The clinical advisor is the link for the student and the preceptor, visiting the student onsite to determine that the student is progressing in a supportive learning environment, in addition to getting to know the preceptor. This role provides the student and preceptor with someone knowledgeable about the course objectives and someone who can troubleshoot any issues that may arise. Despite excellent academic performance and favorable clinical evaluations, the nurse practitioner (NP) student thinks, "I feel like I am fooling everyone. My good grades and positive evaluations are based on luck." Which term best describes the NP student's perceptions?

a. Identity crisis b. Role confusion c. Resocialization process d. Imposter phenomenon Imposter phenomenon Which activity comprises a complementary form of clinical education? a. Evaluating the clinical site b. Performing a student self-evaluation c. Documenting the number of clinical hours completed d. Researching current information about a disease state Researching current information about a disease state Discuss current pathways to earning a doctor of nursing practice (DNP) degree. At present, several paths to the DNP are available. These academic paths

include ADN to DNP, nonnursing baccalaureate degree to DNP, BSN to DNP, postmaster's DNP, and even postdoctorate DNP. Students may enter a program with experiences ranging from little to no nursing experience, several years of nursing experience, some years of nurse practitioner experience, to several years of nurse practitioner experience. According to the American Association of Colleges of Nursing (AACN), all final projects completed during the course of a doctor of nursing practice (DNP) nurse practitioner program should incorporate which component? a. Developing and implementing a research utilization project b. Evaluating a new practice model c. Using evidence to improve practice or patient outcomes

d. Completing a pilot study Using evidence to improve practice or patient outcomes Discuss the oral case study presentation, including its relevance to the nurse practitioner's practice and main components of the presentation. The oral case presentation skill is central to healthcare providers' communication. It allows the nurse practitioner to succinctly convey a clear, organized analysis of a patient's health problem(s) to another provider in order to develop an effective management plan. The case presentation also serves as a method for clinical preceptors and peers to assess the level of expertise a practitioner has regarding a particular problem and to evaluate the assessment and management portion of that patient's care. Lastly, a clearly communicated case presentation enables the nurse practitioner to get a more experienced clinician's opinion about a patient in an efficient, cost-effective manner. The main components of an effective oral case study presentation include (1) introduction or chief complaint; (2) history of present illness; (3) physical examination; (4) diagnostic tests; (5) differential diagnosis; (6) management plan; and (7) summary.

The cardiothoracic nurse practitioner (NP) is providing care to a patient who recently sustained a myocardial infarction (MI) and who may require surgical intervention. Which action by the NP best illustrates consultation? a. Asking another healthcare provider for direction on the patient's treatment plan for coronary artery disease b. Jointly communicating with another healthcare provider about the patient's ethical concerns related to blood transfusion c. Requesting that another healthcare provider accept the patient's ongoing treatment following surgery d. Working with another healthcare professional to determine the patient's need for postoperative home care Asking another healthcare provider for direction on the patient's treatment plan for coronary artery disease

Distinguish among collaboration, consultation, and referral of patients by the nurse practitioner. Collaboration can be defined as a joint communication and decision-making process between healthcare professionals working toward a mutual goal of addressing a patient and family's medical, social, and ethical problems. Consultation can be defined as a request for direction or assistance on a diagnosis or treatment plan from another provider. Referral can be defined as another provider accepting the ongoing treatment of a patient for a specific problem and often for a limited amount of time. Explain how individual professions' isolated evidence base may create barriers for the nurse practitioner (NP) who seeks to implement effective collaborative teams. When seeking to implement effective collaborative teams, barriers faced by the NP can be based on the individual professions' isolated evidence base, which results in a foundation of decision making and distinct communication patterns that can result in role confusion and turf battles. Each discipline perceives itself as having sole expertise, power, and leadership in one care aspect over the discipline.

Describe the evolution of the definition of evidence-based medicine (EBM) to include patient values and preferences. In the early published definitions of EBM, the areas of foci included identifying, critically appraising, and summarizing best current evidence. However, it became clear that evidence alone was not sufficient to make clinical decisions, so in 2000 the Evidence-Based Medicine Working Group presented the second fundamental principle of EBM. This principle specified that clinical decisions, recommendations, and practice guidelines must not only focus on the best available evidence, but they also must include the values and preferences of the informed patient. Summarize the four key assumptions of evidence-based practice (EBP) in nursing. Key assumptions of EBP in nursing practice include (1) nursing is both a science and an applied profession; (2) knowledge is important to professional practice, and there

are limits to knowledge that must be identified; (3) not all evidence is created equal, and there is a need to use the best available evidence; and (4) evidence- based practice contributes to improved outcomes When completing Step 1 of Melnyk and Fineout-Overholt's evidence-based practice (EBP) process, which action does the NP student implement? a. Cultivating a spirit of inquiry b. Formulating a clinical question c. Creating a culture of evidence-based practice d. Searching for high-quality research evidence Formulating a clinical question Explain the purpose of the PICOT method. Prior to finding the best current evidence for clinical decision making, the clinical problem must be identified and translated into a searchable, answerable question. The PICOT method is a widely accepted format for creating clinical questions.

Discuss the primary components of a PICOT question. The primary components of a PICOT question include P: Population/disease (age, gender, ethnicity, with a certain disorder); I: Intervention or variable of interest (therapy, exposure to a disease, risk behavior, prognostic factor); C: Comparison (alternate therapy, placebo or usual practice, absence of risk factor); O: Outcome (risk of disease, accuracy of a diagnosis, rate of occurrence of adverse outcome); and T: Time, which is the time it takes to demonstrate an outcome (i.e., the time required for the intervention to achieve an outcome or time populations are observed for outcome).

When searching for the best research evidence, which step does the nurse practitioner (NP) student complete first? a. Expand the search using the explode option. b. Combine searches generated from PICOT key words. c. Establish inclusion and exclusion criteria. d. Use tools to limit the search to the topic of interest. Establish inclusion and exclusion criteria. Based on the American Association of Critical Care Nurses (AACN) evidence- leveling system, which type of evidence demonstrates the greatest strength? a. Meta-analysis of multiple controlled trials b. Well-designed controlled studies c. Peer-reviewed organizational standards d. Theory-based evidence from multiple case reports Meta-analysis of multiple controlled trials The nurse practitioner (NP) student is seeking to learn more about palliative care patients' perceptions of the meaning of quality of life. Based on the Oxford